Nursing administration forcing us to take too many patients

Tweety, BSN, RN · Jul 19, 2006

I feel your pain. Our VP of Nursing, who is not a nurse, is the same way.

Good luck.

husker-nurse, LPN, LVN · Jul 19, 2006

This does indeed sound like a very dangerous situation; our vented patients are in ICU; I have no answer for you other than to put your concerns IN WRITING to your CEO and keep a copy; the name of the game is CYA....I'm sure someone will have some answers for you!

vamedic4, EMT-P · Jul 19, 2006

Perhaps a nicely written and well thought out editorial in the local newspaper is called for....or a call to your local television station. Nurses are news, and with the unsafe scenario you've described here you might just get some local government reaction to your problem. Worth a shot, especially when taxpayers lives and jobs are affected.

It amazes me how seemingly smart people can make such incredibly stupid decisions.

Best of luck to you!

vamedic4

almost home for the day

lsyorke, RN · Jul 19, 2006

A ratio of 5/1 is not a ratio that I've had the pleasure to work with at any hospital that I've worked out. I understand that this was the norm for your facility and her reasoning is questionable, but 6/1 is the average in N.J., if not more.

soliant12 · Jul 19, 2006

As long as you keep letting them force these patients on you they are going to do it. I do not understand why nurses put up with this nonsense. Give your notice immediately and find another job. IT is not worth the headache putting up with this BS.

I work at a hospital that until the last week or so would close beds once we reached our pt/nurse ratio of 5/1. The unit is a renal tele floor and vented pts/drips/etc are not unusual. 5/1 is pushing the threshold of safe pt care.
Now, the director of nursing for the hospital has decided that she doesn't give a crap about the ratio and that, "we will take more patients"
and it's not her problem we don't have staffing. The other day we had 8 nurses, with the charge nurse, and a census of 40 patients meaning that most nurses had to take 6 pts. Our normal staffing is 10 nurses, as we have 46 beds. Our sister tele unit one floor down has a ratio of 4/1 and does not take vented pts and has a lower pt acuity than us. By the way, I work in MD, so no mandatory ratios.
Basically, if the hospital administration continues this crap, I will be leaving. Our nurse manager refuses to allow us to pull call to cover the unit when we are short nurses, which seems like an easy temporary fix. What can you do when your director of nursing for the hospital has become unsympathetic and is basically forcing you to put your license on the line? Has anyone else encountered a similar situation and what did you do? Really, any suggestions would be helpful.
Thanks

Gabie Baby · Jul 19, 2006

As long as you keep letting them force these patients on you they are going to do it. I do not understand why nurses put up with this nonsense. Give your notice immediately and find another job. IT is not worth the headache putting up with this BS.

What if she's been there long enough to be close to earning a pension and isn't so young any more and doesn't want to have to start over somewhere that might turn out to be as bad or worse?

I do agree with the view that she and her coworkers need to stand up to this DON and refuse, simply refuse, to take more than what they consider a safe number of patiets. I get so weary of nurses who refuse to stand up for themselves, they won't unionize, they just complain and fret and let themselves be pushed around then they quit. I'm not saying for a minute that it's easy to stand up for ourselves. But how else will we ever get things changed?

I would NOT do the TV or newspaper or internet public remarks if you don't wish to be fired stat, especially without first speaking to your bosses, including the DON and the CEO/President/whoever is in charge.

Antikigirl, ASN, RN · Jul 19, 2006

I am agency, and when I first started working at this one hospital (which I am currently trying to be employed with full time) this was the case. But they had a union...and they never really called on the union for help. This time they did..and everyones ratios went back down to safe levels and agency nurses are called in for back up! (which was excellent for me!).

It just took a few nurses to stand together, get the word out, called the ONA (Oregon Nurses Association) and BOOM!

Now our ratio's in med surge alone are 4/1 days, 5/1 eves IF there is a unit secretary and CNA...if not back to 4/1! I am not sure about nights...quite higher ratio I believe...but never heard our night shift complain, and typically they get two CNA's!

I know ICU, Tele, and so on have much lower ratios :).

lifejourney · Jul 19, 2006

I am in nearby Northern Virginia, as of March of this year. I couldn't believe the nurse-patient ratios here in the DC metro area hospitals. I left the hospital setting completely and am working occupational health. It is a far-cry from my previous experience in critical care, but I am not afraid of losing my license or getting sued every time I go to work.

Good luck. There is strength in numbers, and the best time to fight these types of ratios is as they are being phased in. Keep us posted.

TheCommuter, BSN, RN · Jul 20, 2006

Nurses are news, and with the unsafe scenario you've described here you might just get some local government reaction to your problem.

Doctors are news. Frankly, nurses don't garner that degree of public respect or prestige. I am just telling it like it is.

leslie :-D · Jul 20, 2006

if one nurse refuses, then all must refuse.

that's the only way you'll be taken seriously.

even if you have alot of yrs vested in this place and can't afford to quit, sometimes you can't afford not to.

you can always refuse and cite your reasons on paper.

good documentation is critical, should you opt for this route.

if you are fired, you will have something that points to a dangerous pt load.

if you decide to accept the extra pt., you're endangering your pts and your license.

whatever you decide, document everything.

and i would be looking for another job now!

leslie

allnurses Guide · Jul 20, 2006

The flip side of this is, where the patients are coming from. When the ER is backed up and overflowing with admitted patients who have no in house beds, the ER cannot then keep flowing with the constant influx of patients coming through the door and the ambulance bay. Its not any safer for an ER nurse to try to watch over the admitted patients while treating trauma patients either: its a no-win situation for everyone. We had several ICU holdovers the other night in my ED, and no possible way for them to be 1:1 or even 1:2, because you can't cap the only ER in town, diversion is not an option.

Fortunately our union did something about it, when we go over the standard ratios on the floors for nurses, or below the minimum number needed in ER, everyone in the unit gets time and a half to compensate for the increased work load. It makes the hospital much more anxious to try to cover sick calls and high census! Also acknowledges nurses' hard work. But even that gets old after a while. We just plain need more nurses willing to work hospitals, but that's another thread:penguin: